Scutellaria baicalensis

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Scutellaria baicalensis

Common Names

  • Huang Qin
  • Baikal skullcap
  • Chinese skullcap

For Patients & Caregivers

How It Works

Scutellaria baicalensis is used in traditional medicine to treat many medical conditions, but studies in humans are limited.

S. baicalensis, also known as Huang Qin or Chinese skullcap, is a root extract used in traditional medicine. It is often used in combination with other herbs.

Most studies have been done in the lab rather than in humans, and suggest anti-inflammatory and antioxidant activity. Some cancer cell lines undergo cell death when exposed to extracts of this herb, but some compounds in this herb may actually have opposite effects. Larger studies in humans that test safety and effectiveness are needed to determine under what circumstances S. baicalensis may be beneficial.

Purported Uses
  • To treat cancer
    Extracts from this herb cause cell death in some cancer cell lines, but human data are lacking. S. baicalensis has not been studied in clinical trials as a single agent, but has been studied in combination with other herbs in formulations such as PC-SPES and sho-saiko-to.
  • To treat arthritis
    An herbal supplement containing S. baicalensis appeared to reduce symptoms of osteoarthritis. However, it is not known if the herb would exert similar effects by itself, and some supplements containing it have been associated with liver toxicity.
  • To treat hepatitis
    The herbal formulation sho-saiko-to, which contains Huang Qin, has been studied for its possible liver-protectant effects.
Do Not Take If
  • You are taking warfarin or other blood thinners: Laboratory studies suggest Chinese skullcap has similar effects and therefore, may increase bruising and bleeding risks. Clinical relevance has yet to be determined.
  • You are taking statins: In healthy volunteers, Chinese skullcap decreased blood levels of drugs used to lower cholesterol.
  • You are taking Cytochrome P450 substrate drugs: Laboratory studies suggest Chinese skullcap may increase the risk of side effects with these drugs. Clinical relevance has yet to be determined.
Side Effects
  • Liver damage
  • Lung inflammation due to bacterial or viral infection

Case Reports
Acute liver injury: In patients with arthritis, following consumption of a formula containing baicalin derived from S. baicalensis or Chinese skullcap.

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For Healthcare Professionals

Scientific Name
Scutellaria baicalensis
Clinical Summary

Scutellaria baicalensis is an herb used in traditional Chinese medicine to treat a variety of conditions including hepatitis, infections, and cancer. It often is used in combination with other botanicals such as PC-SPES and sho-saiko-to.

Preclinical data suggest that compounds in S. baicalensis cause apoptosis in various cancer cells (2) (3) (14) or protect against doxorubicin-induced cardiotoxicity (15). However, both S. baicalensis root and its main flavonoid baicalin appear to have dose-dependent pro- and anti-angiogenic effects (9). Some constituents may also have neuroprotective (4) (5), anticonvulsant (6), and anti-inflammatory (17) effects.

Studies in humans are quite limited. A preliminary study of S. baicalensis along with metformin appeared to improved glucose tolerance, inflammation, and gut microbiota in patients with type 2 diabetes (23). An herbal supplement containing S. baicalensis reduced symptoms of osteoarthritis (22). However, it is not known if the herb would exert similar effects by itself, and cases of hepatotoxicity with some supplements have been reported (18) (24).

Purported Uses
  • Cancer
  • Arthritis
  • Hepatitis
Mechanism of Action

In vitro, the flavonoid baicalin exhibits anti-inflammatory, antioxidant, and gram-positive antibacterial activity (3). In animal models, attenuation of asthma was attributed to reduced airway injury and restored mitochondrial function (19). Neuroprotective effects of flavonoids were ameliorated by diazepam, a GABA receptor agonist, suggesting that the components influence GABA receptor activity (5).

Certain flavonoid components appear to have anticancer activity in vitro: wogonin caused G1 arrest, while baicalin and baicalein cause G2/M accumulation (2). Baicalin also activated caspase-3, resulting in apoptosis of leukemia-derived T cells. However, low doses of baicalin upregulated expression of multiple angiogenic genes to increase cell proliferation in developing blood vessels, while high doses inhibited angiogenesis by inducing cell death, suggesting dose-dependent dual effects. The compound baicalein exhibited only inhibitory effects (9).

Adverse Reactions

Hepatotoxicity, pneumonitis (7)

Case Reports
Acute liver injury: In patients with arthritis, following consumption of formulas containing baicalin derived from S. baicalensis or Chinese skullcap (18) (24).

Herb-Drug Interactions
  • Anticoagulants / Antiplatelets: Laboratory studies suggest baicalin has antithrombotic activity (12) and may therefore have additive effects. Clinical relevance has yet to be determined.
  • Statins: In healthy volunteers, baicalin decreased blood levels of statin drugs used to lower cholesterol (13).
  • Cytochrome P450 substrates: In vitro, wogonin inhibits CYP1A2 and CYP2C19, and may affect intracellular concentrations of drugs metabolized by these enzymes (16). Clinical relevance has yet to be determined.
  • Solute carrier (SLC) transporters: In vitro, baicalein, baicalin, and wogonin inhibited uptake of substrates mediated by essential SLC transporters, which are important membrane proteins responsible for the cellular influx of various drugs (21). Clinical relevance has yet to be determined.
Dosage (OneMSK Only)
References
  1. Bonham M, Posakony J, Coleman I, Montgomery B, Simon J, Nelson PS. Characterization of chemical constituents in Scutellaria baicalensis with antiandrogenic and growth-inhibitory activities toward prostate carcinoma. Clin Cancer Res 2005;11(10):3905-14.
  2. Chang WH, Chen CH, Lu, FJ. Different effects of baicalein, baicalin, and wogonin on mitochondrial function, glutathione content and cell cycle progression in human hepatoma cell lines. Planta Medica 2002;68:128-32.
  3. Ueda S, Nakamura H, Masutani H, et al. Baicalin induces apoptosis via mitochondrial pathway as prooxidant. Molecular Immunology 2002;38:781-91.
  4. Cheng Y, He G, Mu X, et al. Neuroprotective effect of baicalein against MPTP neurotoxicity: Behavioral, biochemical and immunohistochemical profile. Neurosci Lett. Aug 15 2008;441(1):16-20.
  5. Kim DH, Kim S, Jeon SJ, et al. The effects of acute and repeated oroxylin A treatments on Abeta(25-35)-induced memory impairment in mice. Neuropharmacology. 2008 Oct;55(5):639-47.
  6. Park HG, Yoon SY, Choi JY, et al. Anticonvulsant effect of wogonin isolated from Scutellaria baicalensis. Eur J Pharmacol. Nov 28 2007;574(2-3):112-119.
  7. Takeshita K, Saisho Y, Kitamura K, et al. Pneumonitis induced by Ou-gon (scullcap). Internal Medicine 2001;40:764-8.
  8. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. 1st ed. London: Pharmaceutical Press; 1996.
  9. Zhu D, Wang S, Lawless J, et al. Dose Dependent Dual Effect of Baicalin and Herb Huang Qin Extract on Angiogenesis. PLoS One. 2016;11(11):e0167125.
  10. Lai MY, Hsiu SL, Chen CC, Hou YC, Chao PD. Urinary pharmacokinetics of baicalein, wogonin and their glycosides after oral administration of Scutellariae radix in humans. Biol Pharm Bull. Jan 2003;26(1):79-83.
  11. Tarrago T, Kichik N, Claasen B, Prades R, Teixido M, Giralt E. Baicalin, a prodrug able to reach the CNS, is a prolyl oligopeptidase inhibitor. Bioorg Med Chem. Apr 29 2008.
  12. Lee W, Ku SK, Bae JS. Antiplatelet, anticoagulant, and profibrinolytic activities of baicalin. Arch Pharm Res. 2015;38(5):893-903.
  13. Fan L, Zhang W, Guo D, et al. The effect of herbal medicine baicalin on pharmacokinetics of rosuvastatin, substrate of organic anion-transporting polypeptide 1B1. Clin Pharmacol Ther. 2008 Mar;83(3):471-6.
  14. Takahashi H, Chen MC, Pham H, et al. Baicalein, a component of Scutellaria baicalensis, induces apoptosis by Mcl-1 down-regulation in human pancreatic cancer cells. Biochim Biophys Acta. 2011 Aug;1813(8):1465-74.
  15. Chang WT, Li J, Huang HH, et al. Baicalein protects against doxorubicin-induced cardiotoxicity by attenuation of mitochondrial oxidant injury and JNK activation. J Cell Biochem.2011 Oct;112(10):2873-81.
  16. Li T, Li N, Guo Q, et al. Inhibitory effects of wogonin on catalytic activity of cytochrome P450 enzyme in human liver microsomes. Eur J Drug Metab Pharmacokinet. 2011 Dec;36(4):249-56.
  17. Li L, Bao H, Wu J, et al. Baicalin is anti-inflammatory in cigarette smoke-induced inflammatory models in vivo and in vitro: A possible role for HDAC2 activity. Int Immunopharmacol. 2012 May;13(1):15-22.
  18. Chalasani N, Vuppalanchi R, Navarro V, et al. Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series. Ann Intern Med. 2012 Jun 19;156(12):857-60, W297-300.
  19. Mabalirajan U, Ahmad T, Rehman R, et al. Baicalein reduces airway injury in allergen and IL-13 induced airway inflammation. PLoS One. 2013 Apr 30;8(4):e62916.
  20. Tian X, Cheng ZY, He J, Jia LJ, Qiao HL. Concentration-dependent inhibitory effects of baicalin on the metabolism of dextromethorphan, a dual probe of CYP2D and CYP3A, in rats. Chem Biol Interact.2013 Apr 25;203(2):522-9.
  21. Xu F, Li Z, Zheng J, et al. The inhibitory effects of the bioactive components isolated from Scutellaria baicalensis on the cellular uptake mediated by the essential solute carrier transporters. J Pharm Sci. 2013 Nov;102(11):4205-11.
  22. Arjmandi BH1, Ormsbee LT, Elam ML, et al. A Combination of Scutellaria baicalensis and Acacia catechu Extracts for Short-Term Symptomatic Relief of Joint Discomfort Associated with Osteoarthritis of the Knee. J Med Food. 2014 Jun;17(6):707-13.
  23. Shin NR, Gu N, Choi HS, et al. Combined effects of Scutellaria baicalensis with metformin on glucose tolerance of patients with type 2 diabetes via gut microbiota modulation. Am J Physiol Endocrinol Metab. Jan 1 2020;318(1):E52-e61.
  24. Yang L, Aronsohn A, Hart J, et al. Herbal hepatoxicity from Chinese skullcap: A case report. World J Hepatol. Jul 27 2012;4(7):231-233.
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